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Two types of umbilical venous pulsations and outcome of high-risk pregnancy

2001; Elsevier BV; Volume: 61; Issue: 2 Linguagem: Inglês

10.1016/s0378-3782(00)00126-2

1872-6232

C. Hofstaetter, Mariusz Dubiel, Sæmundur Gudmundsson,

Congenital Heart Disease Studies

Normally, blood flows evenly in the umbilical vein, without fluctuation. A pulsating pattern has been reported during fetal heart failure and asphyxia. Recently we have noticed two types of pulsating pattern; its relationship to adverse outcome is unclear. In a prospective multicenter study, recording of umbilical cord venous blood flow was conducted in high-risk pregnancies admitted for routine artery Doppler. In cases of pulsating flow or signs of vascular resistance in the umbilical artery, the examination was extended to the intra-abdominal part of the umbilical vein. Venous pulsation, single or double, were noted and correlated to perinatal outcome. Venous flow pulsatility was noted in 83 fetuses during 2 years, 26 had a double pulsating pattern, which was closely related to increased vascular resistance in the umbilical artery and perinatal mortality. A single pulsating venous pattern in one location had a good prognosis. In conclusion a double pulsating venous pattern, especially if extending to the cord, is an ominous finding in high-risk pregnancy associated with poor perinatal outcome. A single pulsating pattern predicted a much better outcome and might be an indication for delivery in the high-risk case.